| Course | CIS 450 Informatics in Healthcare |
|---|---|
| Module | Module 5 |
| Paper type | Usability evaluation paper |
| Length | About 1,040 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Health Care Administration |
| Updated | September 2026 |
Free sample paper for CIS 450 Module 5
When the Screen Is the Problem: Usability, Quality and a Medication Reconciliation Redesign
Student Name
Health Care Administration Program, Aspen University
CIS 450: Informatics in Healthcare
Instructor Name
Month Day, Year
When the Screen Is the Problem: Usability, Quality and a Medication Reconciliation Redesign
Health information systems can be powerful and still fail the people who use them. Usability, how effectively, efficiently and satisfyingly users can accomplish tasks, affects speed, errors, safety and staff well-being. This paper examines the usability of a composite hospital's medication reconciliation screen and describes how a small evaluation led to a redesign.
The Problem
At admission, nurses must record each patient's home medications and mark whether to continue, change or stop them. On a composite hospital's medical units, nurses called the reconciliation screen impossible. Reconciliation took an average of 18 minutes per patient, and a pharmacy audit found discrepancies in 29% of reconciled lists.
Why Usability Matters
Usability is not a matter of taste. In a national survey of US physicians, the mean System Usability Scale score for electronic records was 45.9, in the bottom 9% of scores across previous studies and graded as not acceptable, and each one-point improvement in rated usability was associated with 3% lower odds of burnout (Melnick et al., 2020). Poor usability also contributes to errors when screens hide information or invite wrong clicks.
Evaluation Methods
The informatics nurse used two methods. A heuristic evaluation compared the screen against established usability principles, such as visibility of system status, consistency, error prevention and minimal memory load. A small usability test asked five nurses to reconcile a standard test patient while thinking aloud, with time, clicks and errors recorded.
Findings
The table summarizes the main problems found.
| Problem | Principle violated | Effect |
|---|---|---|
| Home medications and hospital orders on separate tabs | Minimize memory load | Nurses toggled and forgot details |
| No indication which items were reviewed | Visibility of status | Items skipped |
| Dose field accepted free text | Error prevention | Ambiguous doses |
| Stop and continue buttons adjacent and same color | Error prevention | Wrong selections |
| Pharmacy fill history hidden in another screen | Recognition over recall | Lists incomplete |
| Inconsistent terms for the same action | Consistency | Confusion |
| No summary before signing | Error prevention | Errors not caught |
Usability Test Results
The five nurses took 11 to 22 minutes, averaged 146 clicks and made nine errors on the test patient, including two continued medications that should have been stopped. Four of five missed the pharmacy fill history entirely. Think-aloud comments included I cannot see what I already did and why are these on different tabs.
Acceptance and Workarounds
When a system is hard to use, people find workarounds, such as writing lists on paper before entering them. The technology acceptance model helps explain why: perceived ease of use and usefulness strongly shape how people use a system, and health care versions of the model add factors such as workflow fit (Holden & Karsh, 2010). Nurses who saw the screen as burdensome used it minimally, reducing its value.
Sociotechnical Fit
Usability is one dimension of a broader sociotechnical system that includes content, workflow, people, organizational policies, regulations and measurement (Sittig & Singh, 2010). The screen's problems interacted with workflow: reconciliation happened during busy admissions, often without pharmacy help. Fixing the interface alone would not fix everything.
The Redesign
Working with the vendor and pharmacy, the hospital redesigned the screen: home medications and orders side by side, a check mark showing reviewed items, structured dose fields, stop and continue buttons separated and colored differently, pharmacy fill history displayed on the same screen and a summary requiring confirmation before signing. Pharmacy technicians began taking medication histories for high-risk admissions.
Results
Retesting with five different nurses showed average time falling to 9 minutes, clicks to 71 and errors to two on the same test patient. Three months after go-live, the pharmacy audit found discrepancies in 14% of lists, down from 29%. Nurses rated the screen far easier to use.
Quality Beyond Usability
System quality also includes accuracy of content, reliability, speed, interoperability and support. The hospital tracks system downtime, response time and help desk tickets alongside usability. A usable screen that is slow or frequently down still fails users.
Building Usability In
Usability should be designed in, not fixed later. The hospital now requires usability testing with real users before any major screen change goes live, includes front-line staff in design reviews and asks vendors for evidence of user-centered design. Small tests with five users catch most major problems at low cost.
The Administrator's Role
Administrators control budgets and priorities for system changes. Treating usability complaints as safety and retention issues, rather than as resistance, helps secure time and vendor attention to fix them.
Measuring Usability Over Time
The hospital now includes a short usability survey in its annual staff survey for the most-used screens and tracks help desk tickets by screen. When scores fall or tickets rise, the informatics team investigates. Usability is treated as an ongoing quality measure, not a one-time project.
Vendor Partnership
Many usability problems can only be fixed by the vendor. The hospital shared its test videos and findings with the vendor's design team, which adopted two of the changes in a general release. Sharing evidence with vendors benefits other hospitals too and strengthens the case for user-centered design.
Usability and Safety Reporting
Some usability problems cause errors that reach patients. The hospital added a category for technology-related problems in its incident reporting system so staff could flag screens that contributed to mistakes. Reviewing these reports helped prioritize which screens to fix first.
Training Versus Design
Organizations often respond to usability problems with more training. Training helps, but it cannot fix a design that invites errors. The hospital adopted a rule: if more than one training session is needed to prevent the same mistake, the design is reviewed.
Accessibility
Usability includes accessibility for users with visual, hearing or motor impairments and for older staff and patients. The redesign added adjustable text size and better color contrast. Accessible design helps everyone, especially during long shifts when fatigue makes small text harder to read.
Conclusion
A medication reconciliation screen that nurses called impossible violated basic usability principles, slowed work and contributed to errors. A heuristic review and a five-person usability test identified specific problems, and a redesign cut time, clicks and discrepancies. National evidence linking poor usability to burnout, and theories of acceptance and sociotechnical fit, show why usability is central to system quality.
References
Holden, R. J., & Karsh, B.-T. (2010). The technology acceptance model: Its past and its future in health care. Journal of Biomedical Informatics, 43(1), 159-172. https://doi.org/10.1016/j.jbi.2009.07.002
Melnick, E. R., Dyrbye, L. N., Sinsky, C. A., Trockel, M., West, C. P., Nedelec, L., Tutty, M. A., & Shanafelt, T. (2020). The association between perceived electronic health record usability and professional burnout among US physicians. Mayo Clinic Proceedings, 95(3), 476-487. https://doi.org/10.1016/j.mayocp.2019.09.024
Sittig, D. F., & Singh, H. (2010). A new sociotechnical model for studying health information technology in complex adaptive healthcare systems. Quality and Safety in Health Care, 19(Suppl. 3), i68-i74. https://doi.org/10.1136/qshc.2010.042085
What the CIS 450 Module 5 instructions ask for
Quality and usability are named in Aspen's CIS 450 catalog listing, and the module's actual instructions stay behind Aspen's login, so a usability evaluation of one screen suited this example. Usability assignments usually ask you to evaluate a system or screen using recognized methods, identify problems and recommend changes, often with evidence on why usability matters. Check whether your prompt names a method such as heuristic evaluation or user testing. Describe your method clearly enough that someone could repeat it. Link each problem to a principle it violates and to its effect on users or patients. Report results after changes if you can, since before-and-after evidence is persuasive. Include accessibility in your review.
Inside the CIS 450 Module 5 example
The paper runs roughly 1,040 words under nineteen headings, with a seven-row findings table. It states the problem, explains why usability matters with national evidence, describes the heuristic review and usability test, and presents the findings table. Test results, acceptance and workarounds, sociotechnical fit, the redesign and results follow. Quality beyond usability, building usability in and the administrator's role come next. Measuring usability over time, vendor partnership, usability and safety reporting, training versus design, and accessibility close the body. A comment beside the burnout evidence explains that design choices affect people as well as productivity. Each redesign change maps back to a numbered problem in the findings table. Accessibility closes the body.
Reading the CIS 450 Module 5 grading rubric
Usability evaluations tend to be graded on sound method, clear findings, links to principles and evidence, and credible results. The method combines expert review with user testing. Findings are specific and mapped to principles. Evidence from a national usability and burnout study, the acceptance model review and the sociotechnical model is cited in APA style. Results are measured before and after with the same test patient. Graders also value attention to accessibility and to the rule that repeated training signals a design problem, both of which show mature judgment about where fixes belong. Front-line nurses' own words from the think-aloud sessions also give the findings credibility that numbers alone cannot. Connecting usability to safety reporting shows awareness of patient harm.
CIS 450 Module 5 help: mistakes that cost marks
A common weakness is listing complaints without a method or principles. Use a recognized approach and name the principle each problem violates. Students also recommend training for problems that design should fix. Another gap is failing to measure results after changes. Include time, errors or satisfaction before and after. Keep test tasks realistic. A tutor can review your findings with you and suggest which principle each problem best fits. Quote a few think-aloud comments, since users' words make problems vivid. Explain how the organization will keep measuring usability after the fix. Mention accessibility and vendor partnership, which many papers overlook, and describe who in the organization owns usability going forward.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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CIS 450 Module 5 questions, answered
What does CIS 450 Module 5 usually ask for?
Aspen's CIS 450 description includes quality and usability related to health care informatics, so a usability evaluation paper is a typical assignment. Check your Aspen classroom for the prompt.
What is a heuristic evaluation?
A review of a system against established usability principles, such as consistency, error prevention and visibility of status.
How many users are needed for a usability test?
Small tests with about five users typically reveal most major usability problems.
Where can I find a free CIS 450 Module 5 sample paper?
The usability evaluation, findings table and redesign results included, appears above. It is the fifth CIS 450 sample.
What is the System Usability Scale in CIS 450 Module 5?
A short standardized questionnaire that produces a usability score from 0 to 100; physicians' electronic record scores averaged 45.9 in one national survey.